The Effect of Hyperglycemia at Admission on Clinical Outcomes after Acute Stroke

ABSTRACT

OBJECTIVE: To clarify the issues about the importance of hyperglycemia in the acute stage of stroke as a poor predictor of clinical outcome, we analyzed the relationship between the glucose level in admission and clinical outcome in the acute stroke patients. METHOD: Twenty-five patients with sudden onset of acute stroke with focal neurological deficit were included in this study. Clinical assessments consisted of the National Institutes of Health Stroke Scale (NIHSS) for neurological impairment and the Korean modified Bathel index (KMBI) for functional status. NIHSS and K-MBI were assessed at admission and at discharge. Plasma glucose level was measured at admission in all patients. Acute hyperglycemia at admission was defined as fasting plasma glucose level more than 140 mg/dl. Statistical analysis were used to compare variables and clinical outcome scores between the normoglycemic and hyperglycemic groups. RESULTS: For the patient with hyperglycemia at admission, the odds ratio for neurological improvement decreased (beta=-0.604) and the odds ratio for functional improvement decreased (beta=-0.553). However, control of the glucose level during the acute stroke was not significantly related to neurological and functional recovery (p>0.05). CONCLUSION: In patients with acute stroke, hyperglycemia at admission was associated with neurological and functional impairments. Therefore, we expect that strict control of hyperglycemia during the acute stroke would improve clinical outcomes.